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Nerve Growth Factor, Endothelin and Spinal Cord Injury in Lower Urinary Tract Dysfunction
Author(s) -
OGAWA Teruyuki,
SEKI Satoshi,
HIRAGATA Shiro,
SASATOMI Kurumi,
KAMO Izumi,
YOKOYAMA Hitoshi,
NISHIZAWA Osamu,
YOSHIMURA Naoki
Publication year - 2009
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/j.1757-5672.2009.00036.x
Subject(s) - dyssynergia , medicine , spinal cord injury , hyperreflexia , spinal cord , anesthesia , urinary bladder , reflex , sphincter , lumbosacral joint , urinary system , urethral sphincter , urology , anatomy , urethra , psychiatry
The lower urinary tract has two main functions: (i) storage and (ii) periodic expulsion of urine, which are regulated by a complex neural control system in the brain and lumbosacral spinal cord. Spinal cord injury at cervical or thoracic levels disrupts voluntary control of voiding, as well as the normal reflex pathways that coordinate bladder and sphincter function. Following an initial areflexic period, detrusor hyperreflexia and detrusor‐sphincter dyssynergia develop due to the plasticity of bladder afferent pathways and the unmasking of reflexes triggered by capsaicin‐sensitive C‐fiber bladder afferents. The plasticity is mediated in part by an increase in nerve growth factors released in the spinal cord and the peripheral target organs, as well as upregulated endogenous endothelin mechanisms.